Knežević Danijel, Batičić Lara, Ćurko-Cofek Božena, Batinac Tanja, Ljubačev Aleksandra, Valenčić Seršić Lara, Laškarin Gordana, Zdravković Marko, Šoštarič Maja, Sotošek Vlatka
Department of Anesthesiology, Reanimatology, Emergency and Intensive Care Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
Int J Mol Sci. 2025 Jun 6;26(12):5453. doi: 10.3390/ijms26125453.
Surgical myocardial revascularization, regardless of the technique used, causes ischemia-reperfusion injury (IRI) in the myocardium mediated by inflammation and degradation of the endothelial glycocalyx (EG). We investigated the difference between on-pump and off-pump techniques in terms of the concentration of proinflammatory interleukin (IL)-18 and the EG degradation products syndecan-1 and hyaluronic acid measured by ELISA in the peripheral and cardiac circulation during open heart surgery and in the early postoperative period. The concentration of IL-18, C-reactive protein (CRP), and cardiac troponin T (cTnT) and the leukocyte count increased statistically significantly in revascularized patients at 24 and 72 h after revascularization compared to the beginning of the procedure and was always statistically significantly higher in on-pump patients. Syndecan-1 and hyaluronic acid only increased in on-pump patients 24 and 72 h after revascularization. IL-18 correlated positively with syndecan-1 and CRP only in the pump setting and with the number of leukocytes in both revascularization regimens 24 and 72 h after the surgery. cTnT and hyaluronic acid did not correlate with IL-18. Our results suggest that IL-18 plays an important role in the early inflammatory response in patients during open heart surgery and in the early postoperative period, leading to additional damage to the EG, while it is probably not responsible for myocardial necrosis. It could serve as a biomarker to identify high-risk patients and as a therapeutic target to reduce inflammation and EG degradation. In addition, measurement of IL-18 could help improve the treatment, recovery, and outcomes of patients after heart surgery.
无论采用何种技术，外科心肌血运重建都会导致心肌缺血再灌注损伤（IRI），这种损伤由炎症和内皮糖萼（EG）降解介导。我们研究了在心脏直视手术期间及术后早期，通过酶联免疫吸附测定法（ELISA）测量外周和心脏循环中促炎白细胞介素（IL）-18浓度以及EG降解产物多配体蛋白聚糖-1和透明质酸，对比体外循环和非体外循环技术之间的差异。与手术开始时相比，血运重建患者在血运重建后24小时和72小时时，IL-18、C反应蛋白（CRP）、心肌肌钙蛋白T（cTnT）浓度及白细胞计数均有统计学显著升高，且体外循环患者这些指标始终显著高于非体外循环患者。多配体蛋白聚糖-1和透明质酸仅在体外循环患者血运重建后24小时和72小时时升高。仅在体外循环情况下，术后24小时和72小时时IL-18与多配体蛋白聚糖-1和CRP呈正相关，在两种血运重建方案中IL-18均与白细胞数量呈正相关。cTnT和透明质酸与IL-18无相关性。我们的结果表明，IL-18在心脏直视手术患者及术后早期的早期炎症反应中起重要作用，导致EG进一步损伤，但其可能并非心肌坏死的原因。它可作为识别高危患者的生物标志物以及减轻炎症和EG降解的治疗靶点。此外，检测IL-18有助于改善心脏手术后患者的治疗、恢复情况及预后。
